1. |
Student Medical Form (all sections must be filled
out) – available online
 Medical
Health History – sections I and II completed by student.
Physical
Exam – section III completed by a medical provider
at exam.
|
|
2. |
PPD same as TB or Mantoux testing.
All incoming nursing students, starting a nursing
program this fall, must have a TWO STEP TB skin test done
in August of 2010. Only exception: if for reasons
of employment you have documentation of a TB skin test done in 2009,
you can meet the nursing requirement by repeating a one step
test in August of 2010. You must provide documentation of both the
2009 and 2010 test results.
|
| 3. |
Immunization Records (provide a copy of your childhood
records) The immunization record must show documentation of
TWO MMRs (Measles, Mumps and Rubella vaccines for all nursing students.
If you do not have documentation of two MMR vaccines, you must either
schedule an appointment with your medical provider to get the 2nd
vaccine, or provide documentation of titers, which are blood tests,
showing immunity to all three infections, or provide medical documentation
of an allergic reaction which would prevent you from getting the MMR
vaccine.
|
4. |
If it has been 2 or more years since your last tetanus booster
(Td) you will need to receive a Tdap injection (Tetanus,
Diphtheria and Pertussis). This is a hospital requirement.
|
| 5. |
Varicella Immunity (Chickenpox) one of the following
is required:
History
of disease noted on the medical health history form
Documentation
of a Varicella titer showing immunity
Documentation
of two administered doses of Varicella vaccine
|
| 6. |
Hepatitis B
First
shot (provide copy of date given)
Second
shot (provide copy of date given)
Third
shot (provide copy of date given)
Hepatitis
B titer done a minimum of 6 weeks after 3rd shot is complete.
|
| 7. |
Hepatitis B Titer This titer is needed to show
immunity to Hepatitis B. If your titer is negative six weeks after
receiving the three shot Hepatitis B series, you will need to complete
a second three shot Hepatitis B series, followed by a titer six weeks
after the sixth shot.
|
| 8. |
Copy of the front and back of your major medical insurance
card. DWU requires that all full time students carry medical
insurance. If you do not have private coverage, you will need to purchase
the insurance offered by DWU through Student Assurance Services at
finalization.
|
| 9. |
Copy of current LPN license (if applicable).
|
| 10. |
If you are an LPN proof of current Health Care Provider
CPR is required. |
This
document is available for